“To Sleep, Perchance to Dream” … on the Couch: The Interpersonal Nature of Dreams and Other Dissociative Processes—A Case Illustration

I present my experiences with a patient who, for a period of time, frequently slept and dreamt during our sessions. I depict the process of shared exploration undertaken by this patient and myself in our desire to understand, along with her dreams, her sleep and the hypnogogic imagery at its borders. In so doing, I hope to communicate a sense of the clinical richness and manifold meanings of the sleep and dreams as they became apparent to us over time. To this end, rather than following standard format, I have organized the case material into a series of related clinical moments, each followed by a set of theoretical considerations.

A brief survey of the relevant “sleep-on-the-couch” literature, culled from the writings of a variety of prerelational theorists (few more recent theorists have specifically addressed the topic) is presented. I turn also to those whose writings helped illuminate the treatment as it unfolded: Sullivan, Winnicott, Bromberg, Benjamin, and, most particularly, to the writings of Bromberg, Davies and Frawley, and Harris and Gold on the related themes of clinical enactment and dissociative process.